Abstract

Background: Hepatitis C virus (HCV) infection is a global problem, and older patients are more likely to develop advanced liver disease. Direct-acting antiviral treatments (DAA) have revolutionized the paradigm of HCV treatment and made its elimination possible. However, hematological and biochemical changes have rarely been discussed.

Methods: This was a retrospective observational study of enrolled patients who received DAA for chronic HCV between Aug 2018 and Mar 2020. Patients were divided into two groups: younger < 65 years and older ≥ 65 years. The HCV genotype, changes in biochemistry and hematologic data before and after treatment, and sustained virologic response at 12weeks after cessation of drug administration were recorded.

Results: Of the 226 enrolled patients, 130 (57.5%) belonged to the younger group and 96 (42.5%) to the older group. Most patients had HCV genotype 2 infections (54.4%), and older patients tended to have genotype 2 infections (70.7% vs. 42.3%). The older patients had significantly lower hemoglobin, platelet, albumin, and BUN levels initially. After treatment, the platelet count and BUN levels significantly improved in older patients. Older patients had higher fibrosis-4 (FIB-4) scores than younger patients before and after treatment. After treatment, the FIB-4 score in the older group showed a significant change (3.90 vs. 2.67; p = 0.001), but the younger group did not (1.97 vs. 1.75; p = 0.05).

Conclusion: Older patients tended to have genotype 2 infections. After DAA treatment, the improvements in platelet count and albumin level were better in older patients than in younger patients. Improvement in FIB-4 was also significant in the older population.